Abstract
We herein report a 50-year-old Japanese woman with breast cancer who complained of blurred vision and central scotoma in her left eye on the 12th day after surgery. Subsequently, the sudden-onset binocular visual disorder progressed, and she was diagnosed with cancer-associated retinopathy (CAR) based on the clinical findings. Although her visual acuity temporarily improved following the start of adjuvant chemotherapy, reductions in her visual acuity progressed once again. After two courses of steroid pulse therapy initiated from the 59th day following the onset of CAR, although her visual field was still constricted, her binocular visual acuity improved from finger movement to 0.8 2 months later. The shorter the period from onset to treatment, the better the prognosis of the visual function. However, a diagnosis is often delayed because the incidence of this disease is very rare. Therefore, it is important to suspect CAR whenever a sudden visual disorder develops in cancer patients. Furthermore, treatment is believed to be effective even if steroid therapy is started up to 2 months from onset.
Highlights
Cancer-associated retinopathy (CAR) is an extremely rare paraneoplastic syndrome that causes subacute retinal vision disorders
CAR caused by a common antigen between tumor cells and the retinal vision system targeted against retinal antigens
Since the adjuvant chemotherapy was necessary for invasive breast carcinoma based on the final pathological diagnosis after radiotherapy, she received 4 cycles of chemotherapy with epirubicin and cyclophosphamide followed by 4 cycles of chemotherapy with docetaxel from the 92th postoperative day
Summary
Cancer-associated retinopathy (CAR) is an extremely rare paraneoplastic syndrome that causes subacute retinal vision disorders. Twelve months following the onset of CAR, the paracentral and peripheral scotoma remain, and she is forced to walk with a cane and cannot drive a car (Fig. 4) She has maintained binocular vision of 1.2. Since the adjuvant chemotherapy was necessary for invasive breast carcinoma based on the final pathological diagnosis after radiotherapy, she received 4 cycles of chemotherapy with epirubicin and cyclophosphamide followed by 4 cycles of chemotherapy with docetaxel from the 92th postoperative day. She has subsequently been maintained on endocrine therapy. The axillary metastasis has disappeared, and there is no evidence of any other recurrence at 16 months after surgery
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